How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $676.08 Median $691.83 Typical High $794.33 | Facility | None | $676.08 | $691.83 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $724.44 Typical High $776.25 | Professional | None | $676.08 | $724.44 | $776.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $9,549.93 Typical High $11,748.98 | Facility | None | $2,238.72 | $9,549.93 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $691.83 | Professional | None | $575.44 | $691.83 | $691.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $109.65 Typical High $109.65 | Professional | 80 · Assistant surgeon | $93.33 | $109.65 | $109.65 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $97.72 Typical High $97.72 | Professional | AS · PA/NP assist | $81.28 | $97.72 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $794.33 Typical High $977.24 | Facility | None | $467.74 | $794.33 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $3,467.37 | Professional | None | $660.69 | $660.69 | $3,467.37 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $354.81 Median $912.01 Typical High $8,317.64 | Facility | None | $354.81 | $912.01 | $8,317.64 |
United Setting Professional Modifier None Typical Low $588.84 Median $870.96 Typical High $1,096.48 | Professional | None | $588.84 | $870.96 | $1,096.48 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $537.03 Typical High $575.44 | Professional | 54 · Surgery only | $501.19 | $537.03 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $107.15 Typical High $114.82 | Professional | 55 · Aftercare only | $100.00 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $72.44 Typical High $77.62 | Professional | 56 · Pre-op care only | $67.61 | $72.44 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $501.19 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $467.74 | $501.19 | $537.03 |
Where Kentucky sits
The same service costs 3.8 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Kentucky· 35th of 51
$692
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.